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Grundy Q, Held F, MacIsaac M, Baugh CM, Campbell EG, Bero L. Quantifying Industry Spending on Promotional Events Using Open Payments Data. JAMA HEALTH FORUM 2024; 5:e241581. [PMID: 38941087 PMCID: PMC11214116 DOI: 10.1001/jamahealthforum.2024.1581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 04/26/2024] [Indexed: 06/29/2024] Open
Abstract
Importance Sponsorship of promotional events for health professionals is a key facet of marketing campaigns for pharmaceuticals and medical devices; however, there appears to be limited transparency regarding the scope and scale of this spending. Objective To develop a novel method for describing the scope and quantifying the spending by US pharmaceutical and medical companies on industry-sponsored promotional events for particular products. Design and Setting This was a cross-sectional study using records from the Centers for Medicare & Medicaid's Open Payments database on payments made to prescribing clinicians from January 1 to December 21, 2022. Main Outcomes and Measures An event-centric approach was used to define sponsored events as groupings of payment records with matching variables. Events were characterized by value (coffee, lunch, dinner, or banquet) and number of attendees (small vs large). To test the method, the number of and total spending for each type of event across professional groups were calculated and used to identify the top 10 products related to dinner events. To validate the method, we extracted all event details advertised on the websites of 4 state-level nurse practitioner associations that regularly hosted industry-sponsored dinner events during 2022 and compared these with events identified in the Open Payments database. Results A total of 1 154 806 events sponsored by pharmaceutical and medical device companies were identified for 2022. Of these, 1 151 351 (99.7%) had fewer than 20 attendees, and 922 214 (80.0%) were considered to be a lunch ($10-$30 per person). Seven companies sponsored 16 031 dinners for the top 10 products. Of the 227 sponsored in-person dinner events hosted by the 4 state-level nurse practitioner associations, 168 (74.0%) matched events constructed from the Open Payments dataset. Conclusions and Relevance These findings indicate that an event-centric analysis of Open Payments data is a valid method to understand the scope and quantify spending by pharmaceutical and medical device companies on industry-sponsored promotional events attended by prescribers. Expanding and enforcing the reporting requirements to cover all payments to all registered health professionals would improve the accuracy of estimates of the true extent of all sponsored events and their impact on clinical practice.
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Affiliation(s)
- Quinn Grundy
- Lawrence Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Fabian Held
- Office of the Deputy Vice-Chancellor (Education), University of Sydney, Sydney, New South Wales, Australia
| | - Meghan MacIsaac
- Lawrence Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Christine M. Baugh
- Center for Bioethics and Humanities, University of Colorado School of Medicine, Aurora
- Division of General Internal Medicine, University of Colorado School of Medicine, Aurora
| | - Eric G. Campbell
- Center for Bioethics and Humanities, University of Colorado School of Medicine, Aurora
- Division of General Internal Medicine, University of Colorado School of Medicine, Aurora
| | - Lisa Bero
- Center for Bioethics and Humanities, University of Colorado School of Medicine, Aurora
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Forbes M, Bhowon Y, Mintzes B. Pharmaceutical company payments to Australian doctors reported to Medicines Australia, 2019-22: a cross-sectional analysis. Med J Aust 2024; 220:425-427. [PMID: 38623760 DOI: 10.5694/mja2.52284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 11/20/2023] [Indexed: 04/17/2024]
Affiliation(s)
- Malcolm Forbes
- University Hospital Geelong, Geelong, VIC
- University of Melbourne, Melbourne, VIC
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Menkes DB, Mintzes B, Macdonald N, Lexchin J. Raising the bar for disclosure of industry payments to doctors. BMJ 2024; 384:e078133. [PMID: 38423552 DOI: 10.1136/bmj-2023-078133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Affiliation(s)
- David B Menkes
- Waikato Clinical Campus, University of Auckland, Hamilton, New Zealand
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Wallis KA, Dikken PJS, Sooriyaarachchi P, Bohnen AM, Donald M. Lessons from the Netherlands for Australia: cross-country comparison of trends in antidepressant dispensing 2013-2021 and contextual factors influencing prescribing. Aust J Prim Health 2024; 30:NULL. [PMID: 38056885 DOI: 10.1071/py23168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 11/14/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND There is concern internationally about increasing antidepressant use. Most antidepressants are prescribed in general practice. The aim of this study was to compare trends in antidepressant dispensing in Australia and the Netherlands over the 9years from 2013 to 2021, and to explore reasons for differences. METHODS A convergent mixed methods study including analysis of publicly available antidepressant dispensing data obtained from Australia's Pharmaceutical Benefits Scheme and Repatriation Pharmaceutical Benefits Scheme and the Dutch Foundation for Pharmaceutical Statistics and a search of relevant literature to compare contextual factors influencing prescribing were undertaken. RESULTS In 2013, antidepressant dispensing rates in Australia were nearly twice as high as those in the Netherlands (82.5 versus 44.3DDD/1000/day) and increased to be more than twice as high by 2021 (115.6 versus 48.8DDD/1000/day). Antidepressant dispensing increased by 40% in Australia over the nine study years, but by only 10% in the Netherlands. Our scan of the literature confirms that while population factors, health system structure, and clinical guideline recommendations are largely consistent across the two countries, a multifaceted approach in the Netherlands involving improved access to non-pharmacological alternatives, initiatives targeting safer antidepressant prescribing, and tight regulation of pharmaceutical industry influence on prescribers, has successfully curtailed increasing antidepressant use. CONCLUSIONS Australia may learn from the Netherlands' approach to redress increasing antidepressant use.
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Affiliation(s)
- Katharine A Wallis
- General Practice Clinical Unit, Medical School, The University of Queensland, Brisbane, Qld 4029, Australia
| | - Pieter J S Dikken
- General Practice Clinical Unit, Medical School, The University of Queensland, Brisbane, Qld 4029, Australia; and Department of General Practice, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - Piumika Sooriyaarachchi
- General Practice Clinical Unit, Medical School, The University of Queensland, Brisbane, Qld 4029, Australia
| | - Arthur M Bohnen
- Department of General Practice, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - Maria Donald
- General Practice Clinical Unit, Medical School, The University of Queensland, Brisbane, Qld 4029, Australia
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Hooimeyer A, Lines T, Mirzaei J, Pande P, Ganeshamoorthy S, Fabbri A, Parker L, Dunn AG, Mintzes B. Conflict of interest policies at Australian medical schools. Intern Med J 2024; 54:62-73. [PMID: 37255333 DOI: 10.1111/imj.16148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 05/28/2023] [Indexed: 06/01/2023]
Abstract
BACKGROUND Pharmaceutical industry exposure is widespread during medical training and may affect education and clinical decision-making. Medical faculties' conflict of interest (COI) policies help to limit this exposure and protect students against commercial influence. AIMS Our aim was to investigate the prevalence, content and strength of COI policies at Australian medical schools and changes since a previous assessment conducted in 2009. METHODS We identified policies by searching medical school and host university websites in January 2021, and contacted deans to identify any missed policies. We applied a modified version of a scorecard developed in previous studies to examine the content of COI policies. All data were coded in duplicate. COI policies were rated on a scale from 0 (no policy) to 2 (strong policy) across 11 items per medical school. Oversight mechanisms and sanctions were also assessed, and current policies were compared with the 2009 study. RESULTS Of 155 potentially relevant policies, 153 were university-wide and two were specific to medical schools. No policies covered sales representatives, on-site sponsored education or free samples. Oversight of consultancies had improved substantially, with 76% of schools requiring preapproval. Disclosure policies, while usually present, were weak, with no public disclosure required. CONCLUSION We found little indication that Australian medical students are protected from commercial influence on medical education, and there has been limited COI policy development within the past decade. More attention is needed to ensure the independence of medical education in Australia.
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Affiliation(s)
- Ashleigh Hooimeyer
- Charles Perkins Centre and School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | | | - Janet Mirzaei
- School of Medicine, University of Notre Dame Sydney, Sydney, New South Wales, Australia
| | - Preshita Pande
- Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Sylviya Ganeshamoorthy
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Alice Fabbri
- Department for Health, University of Bath, Bath, United Kingdom
| | - Lisa Parker
- Charles Perkins Centre and School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Adam G Dunn
- Biomedical Informatics and Digital Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Barbara Mintzes
- Charles Perkins Centre and School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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Rickard E, Carmel E, Ozieranski P. Comparing pharmaceutical company payments in the four UK countries: a cross-sectional and social network analysis. BMJ Open 2023; 13:e061591. [PMID: 36990486 PMCID: PMC10069501 DOI: 10.1136/bmjopen-2022-061591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/31/2023] Open
Abstract
OBJECTIVES To examine the characteristics of pharmaceutical payments to healthcare and patient organisations in the four UK countries. Compare companies spending the most; types of organisations receiving payments and types of payments in the four countries. Measure the extent to which companies target payments at the same recipients in each country and whether it differs depending on the type of recipient. DESIGN Cross-sectional comparative and social network analysis. SETTING England, Scotland, Wales, Northern Ireland. PARTICIPANTS 100 donors (pharmaceutical companies) reporting payments to 4229 recipients (healthcare organisations and patient organisations) in 2015. MAIN OUTCOME MEASURES For each country: payment totals and distribution; average number of common recipients between companies; share of payments to organisations fulfilling different roles in the health ecosystem and payments for different activities. RESULTS Companies prioritised different types of recipient and different types of activity in each country. There were significant differences in the distribution of payments across the four countries, even for similar types of recipients. Recipients in England and Wales received smaller individual payments than in Scotland and Northern Ireland. Overall, targeting shared recipients occurred most frequently in England, but was also common in certain pockets of each country's health ecosystem. We found evidence of reporting errors in Disclosure UK. CONCLUSIONS Our findings suggest a strategic approach to payments tailored to countries' policy and decision-making context, indicating there may be specific vulnerabilities to financial conflicts of interest at subnational level. Payment differences between countries may be occurring in other countries, particularly those with decentralised health systems and/or high levels of independence across its decision-making authorities. We call for a single database containing all recipient types, full location details and published with associated descriptive and network statistics.
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Affiliation(s)
- Emily Rickard
- Department of Social and Policy Sciences, University of Bath, Bath, UK
| | - Emma Carmel
- Department of Social and Policy Sciences, University of Bath, Bath, UK
| | - Piotr Ozieranski
- Department of Social and Policy Sciences, University of Bath, Bath, UK
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Ozieranski P, Saito H, Rickard E, Mulinari S, Ozaki A. International comparison of pharmaceutical industry payment disclosures in the UK and Japan: implications for self-regulation, public regulation, and transparency. Global Health 2023; 19:14. [PMID: 36869318 PMCID: PMC9985252 DOI: 10.1186/s12992-022-00902-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 12/20/2022] [Indexed: 03/05/2023] Open
Abstract
BACKGROUND Self-regulation of payment disclosure by pharmaceutical industry trade groups is a major global approach to increasing transparency of financial relationships between drug companies and healthcare professionals and organisations. Nevertheless, little is known about the relative strengths and weaknesses of self-regulation across countries, especially beyond Europe. To address this gap in research and stimulate international policy learning, we compare the UK and Japan, the likely strongest cases of self-regulation of payment disclosure in Europe and Asia, across three dimensions of transparency: disclosure rules, practices, and data. RESULTS The UK and Japanese self-regulation of payment disclosure had shared as well unique strengths and weaknesses. The UK and Japanese pharmaceutical industry trade groups declared transparency as the primary goal of payment disclosure, without, however, explaining the link between the two. The rules of payment disclosure in each country provided more insight into some payments but not others. Both trade groups did not reveal the recipients of certain payments by default, and the UK trade group also made the disclosure of some payments conditional on recipient consent. Drug company disclosure practices were more transparent in the UK, allowing for greater availability and accessibility of payment data and insight into underreporting or misreporting of payments by companies. Nevertheless, the share of payments made to named recipients was three times higher in Japan than in the UK, indicating higher transparency of disclosure data. CONCLUSIONS The UK and Japan performed differently across the three dimensions of transparency, suggesting that any comprehensive analysis of self-regulation of payment disclosure must triangulate analysis of disclosure rules, practices, and data. We found limited evidence to support key claims regarding the strengths of self-regulation, while often finding it inferior to public regulation of payment disclosure. We suggest how the self-regulation of payment disclosure in each country can be enhanced and, in the long run, replaced by public regulation to strengthen the industry's accountability to the public.
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Affiliation(s)
- Piotr Ozieranski
- Department of Social and Policy Sciences, University of Bath, Claverton Down, Bath, BA2 7AY, UK.
| | - Hiroaki Saito
- Department of Gastroenterology, Sendai Kousei Hospital, Sendai, Miyagi, Japan
| | - Emily Rickard
- Department of Social and Policy Sciences, University of Bath, Claverton Down, Bath, BA2 7AY, UK
| | - Shai Mulinari
- Department of Sociology, Lund University, Lund, Sweden
| | - Akihiko Ozaki
- Department of Breast Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki, Fukushima, Japan
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Interactions with the pharmaceutical industry and the practice, knowledge and beliefs of medical oncologists and clinical haematologists: a systematic review. Br J Cancer 2022; 126:144-161. [PMID: 34599297 PMCID: PMC8727671 DOI: 10.1038/s41416-021-01552-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 08/23/2021] [Accepted: 09/15/2021] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND No previous review has assessed the extent and effect of industry interactions on medical oncologists and haematologists specifically. METHODS A systematic review investigated interactions with the pharmaceutical industry and how these might affect the clinical practice, knowledge and beliefs of cancer physicians. MEDLINE, Embase, PsycINFO and Web of Science Core Collection databases were searched from inception to February 2021. RESULTS Twenty-nine cross-sectional and two cohort studies met the inclusion criteria. These were classified into three categories of investigation: (1) extent of exposure to industry for cancer physicians as whole (n = 11); (2) financial ties among influential cancer physicians specifically (n = 11) and (3) associations between industry exposure and prescribing (n = 9). Cancer physicians frequently receive payments from or maintain financial ties with industry, at a prevalence of up to 63% in the United States (US) and 70.6% in Japan. Among influential clinicians, 86% of US and 78% of Japanese oncology guidelines authors receive payments. Payments were associated with either a neutral or negative influence on the quality of prescribing practice. Limited evidence suggests oncologists believe education by industry could lead to unconscious bias. CONCLUSIONS There is substantial evidence of frequent relationships between cancer physicians and the pharmaceutical industry in a range of high-income countries. More research is needed on clinical implications for patients and better management of these relationships. REGISTRATION PROSPERO identification number CRD42020143353.
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Abstract
Male baldness is physically benign though it is increasingly described as a “disease” based on claims that it is profoundly distressing. The medicalization of baldness was assessed using data extracted from a review of 37 male baldness psychosocial impact studies. Findings revealed most studies likely had commercial influences (78%), represented baldness as a disease (77%), were conducted on biased samples (68%), and advocated for baldness products/services (60%), omitting their limitations (68%). Health psychologists should challenge baldness medicalization so that men can make informed choices about what, if anything, they do with their baldness.
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Grundy Q, Mazzarello S, Brennenstuhl S, Karanges EA. A comparison of educational events for physicians and nurses in Australia sponsored by opioid manufacturers. PLoS One 2021; 16:e0248238. [PMID: 33735203 PMCID: PMC7971255 DOI: 10.1371/journal.pone.0248238] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 02/23/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Educational activities for physicians sponsored by opioid manufacturers are implicated in the over- and mis-prescribing of opioids. However, the implications of promotion to nurses are poorly understood. Nurses play a key role in assessing pain, addressing the determinants of pain, and administering opioid medications. We sought to understand the nature and content of pain-related educational events sponsored by opioid manufacturers and to compare events targeting physicians and nurses. METHODS We conducted a cross sectional, descriptive analysis of pharmaceutical company reports detailing 116,845 sponsored educational events attended by health professionals from 2011 to 2015 in Australia. We included events that were sponsored by manufacturers of prescription opioid analgesics and were pain related. We compared event characteristics across three attendee groups: (a) physicians only; (b) at least one nurse in attendance; and (c) nurses only. We coded the unstructured data using iteratively generated keywords for variables related to location, format, and content focus. RESULTS We identified 3,411 pain-related events sponsored by 3 companies: bioCSL/CSL (n = 15), Janssen (n = 134); and Mundipharma (n = 3,262). Pain-related events were most often multidisciplinary, including at least one nurse (1,964/3,411; 58%); 38% (1,281/3,411) included physicians only, and 5% (166/3,411) nurses only. The majority of events were held in clinical settings (61%) and 43% took the form of a journal club. Chronic pain was the most common event topic (26%) followed by cancer pain and palliative care (18%), and then generic or unspecified references to pain (15%); nearly a third (32%) of event descriptions contained insufficient information to determine the content focus. Nurse-only events were less frequently held in clinical settings (32%; p < .001) and more frequently were product launches (17%; p < .001) and a significantly larger proportion focused on cancer or palliative care (33%; p < .001), generic pain topics (27%; p < .001), and geriatrics (25%; p < .001) than physician-only or multidisciplinary events. DISCUSSION Opioid promotion via sponsored educational events extends beyond physicians to multidisciplinary teams and specifically, nurses. Despite lack of evidence that opioids improve outcomes for long-term chronic non-cancer pain, hundreds of sponsored educational events focused on chronic pain. Regulators should consider the validity of distinguishing between pharmaceutical companies' "promotional" and "non-promotional" activities.
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Affiliation(s)
- Quinn Grundy
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
- Faculty of Medicine and Health, Sydney Pharmacy School, The University of Sydney, Sydney, Australia
- * E-mail:
| | - Sasha Mazzarello
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
| | - Sarah Brennenstuhl
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
| | - Emily A. Karanges
- Faculty of Medicine and Health, Sydney Pharmacy School, The University of Sydney, Sydney, Australia
- Faculty of Medicine, Dentistry and Health, Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
- Orygen, Melbourne, Australia
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Mintzes B. Policing the promotion of prescription medicines - the new Medicines Australia Code of Conduct. Aust Prescr 2021; 44:4-5. [PMID: 33664540 PMCID: PMC7900277 DOI: 10.18773/austprescr.2020.082] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Grundy Q, Millington A, Cussen C, Held F, Dale CM. Promotion or education: a content analysis of industry-authored oral health educational materials targeted at acute care nurses. BMJ Open 2020; 10:e040541. [PMID: 33247018 PMCID: PMC7703418 DOI: 10.1136/bmjopen-2020-040541] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVES To assess the nature, quality and independence of scientific evidence provided in support of claims in industry-authored educational materials in oral health. DESIGN A content analysis of educational materials authored by the four major multinational oral health product manufacturers. SETTING Acute care settings. PARTICIPANTS 68 documents focused on oral health or oral care, targeted at acute care clinicians and identified as 'educational' on companies' international websites. MAIN OUTCOME MEASURES Data were extracted in duplicate for three areas of focus: (a) products referenced in the documents, (b) product-related claims and (c) citations substantiating claims. We assessed claim-citation pairs to determine if information in the citation supported the claim. We analysed the inter-relationships among cited authors and companies using social network analysis. RESULTS Documents ranged from training videos to posters to brochures to continuing education courses. The majority of educational materials explicitly mentioned a product (59/68, 87%), a branded product (35/68, 51%), and made a product-related claim (55/68, 81%). Among claims accompanied by a citation, citations did not support the majority (91/147, 62%) of claims, largely because citations were unrelated. References used to support claims most often represented lower levels of evidence: only 9% were systematic reviews (7/76) and 13% were randomised controlled trials (10/76). We found a network of 20 authors to account for 37% (n=77/206) of all references in claim-citation pairs; 60% (12/20) of the top 20 cited authors received financial support from one of the four sampled manufacturers. CONCLUSIONS Resources to support clinicians' ongoing education are scarce. However, caution should be exercised when relying on industry-authored materials to support continuing education for oral health. Evidence of sponsorship bias and reliance on key opinion leaders suggests that industry-authored educational materials have promotional intent and should be regulated as such.
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Affiliation(s)
- Quinn Grundy
- Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Anna Millington
- Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Cliodna Cussen
- Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Fabian Held
- Office of the Deputy Vice-Chancellor (Education-Enterprise and Engagement), The University of Sydney, Sydney, New South Wales, Australia
| | - Craig M Dale
- Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
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McInnes E, Harvey G, Hiller JE, Phillips R, Page T, Wiechula R. Factors affecting procurement of wound care products: a qualitative study of hospital managers and clinicians. AUST HEALTH REV 2020; 45:66-73. [PMID: 33028462 DOI: 10.1071/ah19250] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 05/28/2020] [Indexed: 11/23/2022]
Abstract
Objective To identify factors that influence procurement and disinvestment decisions for wound care products in the acute care setting. Methods A qualitative descriptive study was undertaken. Eighteen face-to-face semi-structured interviews were conducted with purposively sampled senior clinical and non-clinical managers from three Australian acute care hospitals with responsibility for consumables procurement and disinvestment decisions. Data were coded and analysed thematically. Results Three main themes (Systems and triggers, Evidence-free zone, Getting the governance right) with sub-themes were identified that reflect that: (1) procurement processes were often ad hoc and workarounds common. Disinvestment was poorly understood and opportunities were missed to reduce use of low value products ; (2) product selection was commonly based on clinician preference, contractual obligations and information from industry representatives; and (3) improved evidence-based governance and processes are needed to connect procurement and disinvestment decisions and to minimise the influences of clinician preference and industry representatives on product selection. Conclusions Systematic and evidence-based approaches are needed to strengthen procurement and disinvestment decisions related to consumables such as wound care products and to minimise the purchasing of low-value products Decision-making frameworks should consider cost and clinical effectiveness and enable the identification of opportunities to disinvest from low-value products. What is known about the topic? High volume-low unit cost healthcare consumables such as wound care products are a major component of healthcare expenditure. Disinvestment from low-value wound care products has potential to improve patient outcomes and optimise health resources. What does this paper add? Disinvestment was poorly understood and considered in isolation from procurement decisions. Procurement decisions were rarely informed by research evidence, with clinicians exercising considerable freedom to make purchasing decisions based on product preference and industry information. Frameworks and guidelines are needed to guide procurement and disinvestment decision-making for wound care products. What are the implications for practitioners? New models for procurement and disinvestment decision-making for wound care products could help to strengthen decision-making processes, facilitate evidence-based product choices and also prompt consideration of removal of low-value products.
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Affiliation(s)
- Elizabeth McInnes
- Nursing Research Institute - St Vincent's Health Australia Sydney, St Vincent's Hospital Melbourne and Australian Catholic University, Daniel Mannix Building, Brunswick Street, Fitzroy, Vic 3000, Australia; and School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Daniel Mannix Building, Brunswick Street, Fitzroy, Vic 3000, Australia. ; and Corresponding author.
| | - Gill Harvey
- Adelaide Nursing School, University of Adelaide, Adelaide Health and Medical Sciences Building, Corner of North Terrace and George Street, Adelaide SA 5005, Australia. ; ;
| | - Janet E Hiller
- Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University of Technology, John Street, Hawthorn, Vic 3122, Australia. ; and School of Public Health, University of Adelaide, 57 North Terrace, Adelaide SA 5005, Australia
| | - Rosemary Phillips
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Daniel Mannix Building, Brunswick Street, Fitzroy, Vic 3000, Australia.
| | - Tamara Page
- Adelaide Nursing School, University of Adelaide, Adelaide Health and Medical Sciences Building, Corner of North Terrace and George Street, Adelaide SA 5005, Australia. ; ;
| | - Rick Wiechula
- Adelaide Nursing School, University of Adelaide, Adelaide Health and Medical Sciences Building, Corner of North Terrace and George Street, Adelaide SA 5005, Australia. ; ;
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Pokorny AMJ, Bero LA, Moynihan R, Mintzes BJ. Industry payments to Australian medical oncologists and clinical haematologists: a cross-sectional analysis of publicly available disclosures. Intern Med J 2020; 51:1816-1824. [PMID: 32744396 DOI: 10.1111/imj.15005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/12/2020] [Accepted: 07/23/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Payments to medical oncologists and clinical haematologists can negatively affect prescribing practice, but the extent of payments to these specialists is unknown in Australia. AIMS To analyse the extent of payments from the pharmaceutical industry to Australian cancer physicians as reported during the first collated period of the Disclosure Australia website. METHODS We performed a retrospective, cross-sectional analysis of payments made from November 2018 to April 2019, using a file downloaded from the Disclosure Australia website. We checked the names of listed medical practitioners against Medical Board of Australia records to assign specialties. The number of medical oncologists, clinical haematologists, other specialist physicians and non-specialist physician medical practitioners was calculated, along with the payments to each of these groups. RESULTS A total of A$7 332 407 was paid to 2775 medical practitioners. Of these, 236 were medical oncologists, 189 were haematologists and 1145 were other specialist physicians. This represents 31.7% of Australian medical oncologists and 30.9% of Australian haematologists, compared with 11.7% of all other specialist physicians and 1.1% of all other non-specialist physician medical practitioners. Medical oncologists received significantly higher payments (median A$2131.26) than other specialist physicians (median A$1376.00, 2-tailed P = 0.004) and other medical practitioners (median A$709.00, 2-tailed P < 0.001), while haematologists received significantly higher payments (median A$1519.95) than other medical practitioners (2-tailed P < 0.001), but similar payments to other specialist physicians (2-tailed P = 0.08). CONCLUSIONS Australian cancer physicians receive payments at a higher proportional frequency and in greater dollar amounts than other specialist physicians and other medical practitioners in general.
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Affiliation(s)
- Adrian M J Pokorny
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Department of Medical Oncology, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - Lisa A Bero
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Raymond Moynihan
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Barbara J Mintzes
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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Ozaki A, Saito H, Senoo Y, Sawano T, Shimada Y, Kobashi Y, Yamamoto K, Suzuki Y, Tanimoto T. Overview and transparency of non-research payments to healthcare organizations and healthcare professionals from pharmaceutical companies in Japan: Analysis of payment data in 2016. Health Policy 2020; 124:727-735. [DOI: 10.1016/j.healthpol.2020.03.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 03/26/2020] [Accepted: 03/31/2020] [Indexed: 11/28/2022]
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Baur X, Soskolne CL, Bero LA. How can the integrity of occupational and environmental health research be maintained in the presence of conflicting interests? Environ Health 2019; 18:93. [PMID: 31684947 PMCID: PMC6829996 DOI: 10.1186/s12940-019-0527-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 09/22/2019] [Indexed: 05/23/2023]
Abstract
BACKGROUND The sciences, and especially the research subspecialties of occupational and environmental health, are being misused. The misuse serves to interfere with the advancement of policies that depend on rational evidence needed for policies to protect public health. METHODS We selectively surveyed the independent scientific literature. In addition, the efforts of respected international professional organizations of scientists whose focus is on maintaining and improving public health have been considered. This commentary is unique in assembling not only the factual basis for sounding alarms about significant bias in occupational and environmental health research, but also about the manipulative mechanisms used, and, in turn, the methods needed to keep science honest. RESULTS Scientific integrity is based on the principle that research is conducted as objectively as possible; it cannot be compromised by special interests whose primary goals are neither to seek truth nor to protect human health. Evidence demonstrates a significant risk of bias in research reports sponsored by financial interests. Practices of corporate malfeasance include the orchestrated contamination of editorial boards of peer-reviewed scientific journals with industry apologists; interference with activities of national regulatory bodies and international review panels engaged in safeguarding occupational and public health; constructing roadblocks by capitalizing on uncertainty to undermine scientific consensus for much-needed government regulation of carcinogenic, endocrine-disrupting and/or immunotoxic agents; promoting "causation" criteria that lack foundation and effectively block workers' access to legal remedies for harms from occupational exposures resulting in morbidity and premature mortality; and, violating standards of professional conduct by seducing reputable scientists with financial incentives that make them beholden to corporate agendas. CONCLUSIONS Well-orchestrated assaults on science continue unabated and must now be met head-on. Success could be achieved by promoting and protecting the integrity of research. Furthermore, avoiding influence by conflicted corporate affiliates in occupational and public health regulations is needed. Identifying, managing and, ideally, eliminating corporate influence on science and science policy are needed to protect research integrity. Protecting the public's health, preventing disease, and promoting well-being must be the unambiguous goals of research in occupational and environmental health.
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Affiliation(s)
- Xaver Baur
- University of Hamburg, Hamburg, Germany; European Society for Environmental and Occupational Medicine, P.O. Box 370514, D-14135 Berlin, Germany
| | - Colin L. Soskolne
- University of Alberta, School of Public Health, 3-300 Edmonton Clinic Health Academy, 11405 - 87 Avenue, Edmonton, AB T6G 1C9 Canada
- Health Research Institute, University of Canberra, Canberra, Australia
| | - Lisa A. Bero
- Medicines Use and Health Outcomes, The University of Sydney, Charles Perkins Centre, D17, The Hub, 6th floor, Sydney, NSW 2006 Australia
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17
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Behdarvand B, Karanges EA, Bero L. Pharmaceutical industry funding of events for healthcare professionals on non-vitamin K oral anticoagulants in Australia: an observational study. BMJ Open 2019; 9:e030253. [PMID: 31434780 PMCID: PMC6707659 DOI: 10.1136/bmjopen-2019-030253] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES To describe the nature, frequency and content of non-vitamin K oral anticoagulant (NOAC)-related events for healthcare professionals sponsored by the manufacturers of the NOACs in Australia. A secondary objective is to compare these data to the rate of dispensing of the NOACs in Australia. DESIGN AND SETTING This cross-sectional study examined consolidated data from publicly available Australian pharmaceutical industry transparency reports from October 2011 to September 2015 on NOAC-related educational events. Data from April 2011 to June 2016 on NOAC dispensing, subsidised under Australia's Pharmaceutical Benefits Scheme (PBS), were obtained from the Department of Health and the Department of Human Services. MAIN OUTCOME MEASURES Characteristics of NOAC-related educational events including costs (in Australian dollars, $A), numbers of events, information on healthcare professional attendees and content of events; and NOAC dispensing rates. RESULTS During the study period, there were 2797 NOAC-related events, costing manufacturers a total of $A10 578 745. Total expenditure for meals and beverages at all events was $A4 238 962. Events were predominantly attended by general practitioners (42%, 1174/2797), cardiologists (35%, 977/2797) and haematologists (23%, 635/2797). About 48% (1347/2797) of events were held in non-clinical settings, mainly restaurants, bars and cafes. Around 55% (1551/2797) of events consisted of either conferences, meetings or seminars. The analysis of the content presented at two events detected promotion of NOACs for unapproved indications, an emphasis on a favourable benefit/harm profile, and that all speakers had close ties with the manufacturers of the NOACs. Following PBS listings relevant to each NOAC, the numbers of events related to that NOAC and the prescribing of that NOAC increased. CONCLUSIONS Our findings suggest that the substantial investment in NOAC-related events made by four pharmaceutical companies had a promotional purpose. Healthcare professionals should seek independent information on newly subsidised medicines from, for example, government agencies or drug bulletins.
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Affiliation(s)
- Behrad Behdarvand
- Charles Perkins Centre and School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Emily A Karanges
- Charles Perkins Centre and School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Lisa Bero
- Charles Perkins Centre and School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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Leonardo Alves T, Lexchin J, Mintzes B. Medicines Information and the Regulation of the Promotion of Pharmaceuticals. SCIENCE AND ENGINEERING ETHICS 2019; 25:1167-1192. [PMID: 29721844 PMCID: PMC6647516 DOI: 10.1007/s11948-018-0041-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 03/06/2018] [Indexed: 06/03/2023]
Abstract
Many factors contribute to the inappropriate use of medicines, including not only a lack of information but also inaccurate and misleading promotional information. This review examines how the promotion of pharmaceuticals directly affects the prescribing and use of medicines. We define promotion broadly as all actions taken directly by pharmaceutical companies with the aim of enhancing product sales. We look in greater detail at promotion techniques aimed at prescribers, such as sales representatives, pharmaceutical advertisements in medical journals and use of key opinion leaders, along with the quality of information provided and the effects thereof. We also discuss promotion to the public, through direct-to-consumer advertising, and its effects. Finally, we consider initiatives to regulate promotion that come from industry, government and nongovernmental organizations.
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Affiliation(s)
- Teresa Leonardo Alves
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, WHO Collaborating Centre for Pharmaceutical Policy and Regulation, PO Box 80 082, 3508 TB, Utrecht, The Netherlands.
| | - Joel Lexchin
- Faculty of Health, York University, Toronto, ON, Canada
- University Health Network, Toronto, ON, Canada
| | - Barbara Mintzes
- Faculty of Pharmacy and Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
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Lee KC, Chuang SK, Jazayeri HE, Koch A, Eisig SB. Industry Payments in Oral and Maxillofacial Surgery: A Review of 112,448 Payments From a National Disclosure Program. J Oral Maxillofac Surg 2019; 77:676-684. [DOI: 10.1016/j.joms.2018.11.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 11/19/2018] [Indexed: 11/26/2022]
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20
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Parker L, Karanges EA, Bero L. Changes in the type and amount of spending disclosed by Australian pharmaceutical companies: an observational study. BMJ Open 2019; 9:e024928. [PMID: 30782921 PMCID: PMC6377522 DOI: 10.1136/bmjopen-2018-024928] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES To describe and quantify disclosed payments from the pharmaceutical industry to the healthcare sector, and to examine the impact of the 2015 changes to Australia's self-regulated system of transparency. DESIGN Observational database study. SETTING Australia. PARTICIPANTS Publicly available reports submitted by members of Australian pharmaceutical industry trade organisations, Medicines Australia and the Generic and Biosimilar Medicines Association (GBMA) (October 2011-December 2017). EXPOSURE Changes to transparency reporting requirements with the updates of pharmaceutical industry Codes of Conduct in 2015. MAIN OUTCOME MEASURES Elements of healthcare sector spending that members of industry organisations are required to publicly disclose; cumulative amount of disclosed spending (monthly average) in the year prior to and following the revision. RESULTS There was a 34.1% reduction in disclosed spending from Medicines Australia member companies in the year after the 2015 changes to the Code of Conduct were introduced ($A89 658 566 in the preceding year, October 2014-September 2015; $A59 052 551 in the following year). The new Code allowed for reduced reporting of spending on food and beverages at events and for sponsored healthcare professionals. However, there was enhanced transparency around identification of individual health professionals receiving payments. GBMA member reporting totalled $A2 580 402 in the year prior to the revision, then ceased. CONCLUSIONS This study shows the limitations of a self-regulatory system around industry disclosure of spending. We advocate for robust regulatory systems, such as legislation, to promote mandatory long-lasting public transparency.
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Affiliation(s)
- Lisa Parker
- School of Pharmacy Faculty of Medicine & Health, The University of Sydney Charles Perkins Centre, Sydney, New South Wales, Australia
| | - Emily A Karanges
- School of Pharmacy Faculty of Medicine & Health, The University of Sydney Charles Perkins Centre, Sydney, New South Wales, Australia
| | - Lisa Bero
- School of Pharmacy Faculty of Medicine & Health, The University of Sydney Charles Perkins Centre, Sydney, New South Wales, Australia
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21
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Mulinari S, Ozieranski P. Disclosure of payments by pharmaceutical companies to healthcare professionals in the UK: analysis of the Association of the British Pharmaceutical Industry's Disclosure UK database, 2015 and 2016 cohorts. BMJ Open 2018; 8:e023094. [PMID: 30344175 PMCID: PMC6196800 DOI: 10.1136/bmjopen-2018-023094] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To analyse the section of Disclosure UK that pertains to healthcare professionals (HCPs) in order to provide insight into the database's structure and content and suggest ways to improve its transparency. DESIGN AND PARTICIPANTS Cohort study of drug companies and HCPs in the 2015 and 2016 versions of Disclosure UK. RESULTS Companies report transfers of value (ToVs) to named HCPs or, where an HCP declines to consent, in aggregate. Only a limited number of variables describe the recipient HCP and the ToV, precluding refined analyses. In 2015, 107 companies reported 54 910 ToVs worth ₤50 967 728. In 2016, 109 companies reported ToVs but spending decreased by 7.3%. The spending was concentrated: the top 10 spenders reported about 50% of the total value, with consultancy-related payments comprising over 70%, and the rest being costs for events. In 2015, 55.5% (30 478) of ToVs worth ₤24 428 619 (47.9%) were disclosed at the individual HCP level, increasing to 64.5% (32 407) and ₤28 145 091 (59.2%) in 2016. Despite increased individual-level disclosure in 2016, the median number of ToVs reported by each company at the individual level was only 57.7%, with 25% of companies reporting less than 38.6%. We found little agreement (62%-48% in 2015 and 46%-30% in 2016) between HCP consent rates that we calculated based on information in the database and those provided by companies. CONCLUSIONS Key deficiencies in Disclosure UK include: insufficient information on payments and recipients, a relatively low HCP consent rate for individual-level disclosure, differences in consent rates across companies and payment types, and reporting ambiguities or inconsistencies. We employ these findings to develop recommendations for improving transparency, including an easily interpretable consent rate statistic that allows for comparison across years, firms and countries. If deficiencies remain unresolved, the UK should consider introducing legislation requiring mandatory disclosure to allow for adequate tracking of industry payments.
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Affiliation(s)
- Shai Mulinari
- Department of Sociology, Lund University, Lund, Sweden
| | - Piotr Ozieranski
- Department of Social and Policy Sciences, University of Bath, Bath, UK
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23
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Mintzes B. The marketing of testosterone treatments for age-related low testosterone or 'Low T'. Curr Opin Endocrinol Diabetes Obes 2018; 25:224-230. [PMID: 29570470 DOI: 10.1097/med.0000000000000412] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW To summarize the research evidence on promotion of testosterone for 'Low T', or age-related hypogonadism. RECENT FINDINGS Marketing of testosterone for 'Low T' has relied on strategies that are inadequately regulated to prevent off-label promotion, such as unbranded 'disease-awareness' advertising campaigns targeting the general public, sponsored continuing medical education (CME) and ghostwriting. A recent US analysis of television advertising exposure levels versus insurance claims found that both unbranded 'disease-awareness' advertising and branded ads were associated with increased rates of testosterone testing, treatment initiation, and treatment without prior testing. Exposés of sponsored CME and ghostwriting indicate misrepresentation of the research evidence on the sequelae of untreated low testosterone and on treatment efficacy. In the United States, advertising to the general public ceased in 2014 after the Food and Drug Administration changed product labeling to clarify that testosterone is only indicated for pathological hypogonadism. Unbranded 'disease-awareness' advertising to the general public and 'Low T' messages for health professionals have continued elsewhere. SUMMARY The review of the experience of promotion of testosterone for 'Low T' and research evidence on effects of advertising targeting the public highlights the need for improved regulation of unbranded 'disease awareness' advertising to ensure adequate protection of public.
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Affiliation(s)
- Barbara Mintzes
- Charles Perkins Centre and Faculty of Pharmacy, University of Sydney, Sydney, New South Wales, Australia
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Mintzes B, Swandari S, Fabbri A, Grundy Q, Moynihan R, Bero L. Does industry-sponsored education foster overdiagnosis and overtreatment of depression, osteoporosis and over-active bladder syndrome? An Australian cohort study. BMJ Open 2018; 8:e019027. [PMID: 29440213 PMCID: PMC5829862 DOI: 10.1136/bmjopen-2017-019027] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Revised: 10/25/2017] [Accepted: 11/28/2017] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES To investigate patterns of industry-sponsored educational events that focus on specific health conditions for which there are concerns about overdiagnosis and overtreatment. DESIGN AND SETTING This retrospective cohort study examines publicly reported industry-sponsored events in Australia from October 2011 to September 2015 for three conditions potentially subject to overdiagnosis and overtreatment: depression, osteoporosis and overactive bladder. We used a database of transparency reports to identify events with a focus on depression, osteoporosis and overactive bladder and compared these with other sponsored events. We hypothesised that companies marketing treatments for each condition would sponsor related events and that target audiences would mainly work in primary care, reflecting a broad patient population. MAIN OUTCOME MEASURES Event and attendee characteristics, sponsoring companies, related marketed treatments, cost-effectiveness ratings and dispensing rates. RESULTS Over the study period, we identified 1567 events focusing on depression, 1375 on osteoporosis and 190 on overactive bladder (total n=3132, with 96 660 attendees). These events were attended by primary care doctors more often than sponsored events without a focus on these three conditions: relative risk (RR)=3.06 (95% CI 2.81 to 3.32) for depression, RR=1.48 (95% CI 1.41 to 1.55) for osteoporosis and RR=2.59 (95% CI 2.09 to 3.21) for overactive bladder. Servier, which markets agomelatine and AstraZeneca (quetiapine) sponsored 51.2% and 23.0% of depression events, respectively. Amgen and GlaxoSmithKline, which co-market denosumab, sponsored 49.5% of osteoporosis events and Astellas and Commonwealth Serum Laboratories (CSL) (mirabegron and solifenacin) sponsored 80.5% of overactive bladder events. CONCLUSIONS This 4-year overview of industry-sponsored events on three overdiagnosed and overtreated conditions found that primary care clinicians were often targeted, dinner was often provided and that a few companies sponsored most events. In most cases, sponsors' products are not cost-effective choices for the specified condition. This pattern highlights the need for professional education to be free of commercial sponsorship.
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Affiliation(s)
- Barbara Mintzes
- Charles Perkins Centre and Faculty of Pharmacy, University of Sydney, Camperdown, NSW, Australia
| | - Swestika Swandari
- Makassar Health Training Centre, Ministry of Health, Makassar, Indonesia
| | - Alice Fabbri
- Charles Perkins Centre and Faculty of Pharmacy, University of Sydney, Camperdown, NSW, Australia
- Centre for Research in Medical Pharmacology, University of Insubria, Varese, Italy
| | - Quinn Grundy
- Charles Perkins Centre and Faculty of Pharmacy, University of Sydney, Camperdown, NSW, Australia
| | - Ray Moynihan
- Faculty of Health Sciences and Medicine, Bond University, Robina, Queensland, Australia
| | - Lisa Bero
- Charles Perkins Centre and Faculty of Pharmacy, University of Sydney, Camperdown, NSW, Australia
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